Individual
MR. COREY LAMAR GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 784-8138
Mailing address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 784-8138
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/19/2012
Last updated
05/29/2025
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